Care Management

Live your healthiest life with programs and services at no additional cost to you.

Paving the way to wellness and self-management

Get support to live healthier. Find out which programs and services are included with your plan so you can get the help you need.

Connect with our Care Management team for support. Call us at 702-797-2100 or toll-free 1-877-487-6659, TTY 711.

Need a little help managing life’s demands? Our medical management social workers are ready to assist you.

Medical management social workers can help with:

  • Information on community resources
  • Financial, housing and transportation needs
  • Care coordination with the health care system
  • Advanced directive education

This program is available to members of all ages.

Cannabis dependency help

Have you tried quitting and are experiencing the following symptoms?

  • Anxiety
  • Anger/aggression
  • Nervousness/irritability
  • Sleep disturbance
  • Headaches
  • Sweating
  • Appetite changes

If so, you could be facing Cannabis Withdrawal Syndrome (CWS).

Self-Refer to our Cannabis Care Program

Our Cannabis Care Program is available to Health Plan of Nevada pediatric, young-adults, adults, and pregnant and lactating members at no additional cost. To self-refer to this program, fill out the Care For Me form.

Understanding Cannabis Use Disorder

Cannabis use disorder, also known as marijuana addiction, happens when an individual can’t stop using the drug even though it interferes with many aspects of their life. Marijuana addiction, though often downplayed, is a serious issue affecting millions of people. Understanding what it involves, its prevalence and the impact on health is an important step in the journey towards recovery.

The Path to Long-Term Recovery

Overcoming addiction can be challenging, but with the right approach and professional assistance, it’s possible.

After you’ve been discharged from the hospital, a referral will be sent on your behalf to our Cannabis Care Program. Once the referral is received, a nurse educator will call you within 24-36 hours to assess your health care needs. Your nurse will work with you and your care team for 60 days.

Your nurse educator will:

  • Offer a safe and non-judgmental space where you can share your experiences, learn from others and receive emotional support
  • Provide science-based education on the effects of high dose THC and contaminated products, possible interactions with other medications, and side effects associated with cannabis use, withdrawal symptoms and quitting
  • Share coping strategies (increase hydration, get plenty of sleep and take warm showers), tips to manage triggers and focus on positive activities (exercise, meditation, reading, etc.)
  • Help ensure the right systems are in place and refer you to health care providers, professional counseling, support groups and community resources/programs
  • Discuss the benefits of regular and consistent doctor visits to monitor continuation of care

Overcoming Addiction is Achievable

Once you have taken the steps to overcome addiction, it’s crucial to focus on preventing relapse. This involves ongoing support, the right mindset, commitment and making healthy lifestyle choices that promote sobriety.

Are you currently using marijuana and experiencing the following symptoms?

  • Continuous nausea and dehydration
  • Screaming while vomiting
  • Abdominal pain and discomfort
  • Loss of appetite/weight
  • Test results positive for cannabis

If so, you could be experiencing Cannabis Hyperemesis Syndrome (CHS).

The Care For Me program nurse is your single point of contact for your healthcare journey. Let us help you with care coordination, education about your condition, and assistance with managing your diagnosis and symptoms.

We partner with your primary care provider (PCP), caregivers, and other health care professionals to help with:

  • Needs after hospitalization, emergency room or urgent care visit
  • Follow‑up appointments and phone calls
  • Specialist and procedure appointments
  • Medication review
  • Health education
  • Referrals and prior authorizations
  • Resources for social and insurance issues
  • Transitioning to other health care programs or services

To self-refer to this program, fill out the Care For Me form or send a message to the Care For Me program team. 

Call 702-797-2100, TTY 711 to connect with your Care For Me program nurse. If calling after 5 p.m., the Access Center is available toll‑free at 1-800-288-2264, TTY 711.

Simplifying your health care journey. Our case managers are registered nurses (RN).

They work closely with you and specialty providers to find solutions to your specific health care needs for conditions like:

  • Congestive heart failure
  • Hypertension
  • Heart disease
  • Diabetes  
  • Chronic obstructive pulmonary disease (COPD)
  • Asthma
  • HIV
  • Other complex conditions such as cystic fibrosis, cerebral palsy and sickle cell anemia

This program is available to adult members age 18+ with complex health needs.

Improving health and well-being with patient-centered care. Whole person care is the coordination of medical, mental health and social services through a patient-centered approach. This program is for adults age 18+ with complex medical and mental health needs.

High Risk Pediatric Case Management (HRPeds)

Caring for medically fragile children. It’s our goal to enhance the quality of life for our youngest members and to minimize disability and illness.

Our team of highly skilled nurses provide quality care, tailored to the child’s unique medical needs, including:

  • Complex medical conditions
  • Special health care needs
  • Autism

This program is for members under the age of 18 with high-risk needs.

High Risk Case Management for Pregnancy (HROB)

Managing high-risk pregnancies and preparing for childbirth. Our case managers are registered nurses. They work closely with you and your doctor to help lower the risk of complications during pregnancy and delivery. If you have any pregnancy benefit questions, please call 702-797-2100 or toll-free 1-877-487-6659, TTY 711.

Feel better and live happier. Our compassionate team of licensed complex case managers provide support to members with mental health and substance use issues.

They can help with things like:

  • Substance use treatment including women who are pregnant who need substance use care
  • Depression
  • Severe mental Illness
  • Severe emotional disturbances

This program is for members of all ages. To find out more, call 702-364-1484 or toll-free 1-800-873-2246, TTY 711.

Providing care and comfort at the end of life. Supportive care is for members 18 and older with life-threatening or terminal illnesses, such as cancer or kidney failure. This program includes care coordination with pain and symptom management, assistance with decision-making, and end-of-life care.

Health care advice. Just a phone call away. If you’re unsure about your condition, our 24/7 advice nurse may be able to help. Our nurse is available to answer questions, provide self-care advice and help you decide whether to seek urgent careemergency care, or schedule an appointment with your provider. Call toll-free 1-800-288-2264, TTY 711.

Your health. Your way. Attend weekly livestream classes, watch on-demand health education videos and/or schedule a phone consultation with one of our health educators at no additional cost to you. To speak with a certified educator or registered dietitian, please call 702-877-5356 or toll-free 1-800-720-7253, Monday through Friday, 8 a.m. to 5 p.m.

Take control of your health with the help of a registered nurse. Get personalized support to self-manage your prediabetes, diabetes, asthma or stage 3 chronic kidney disease (CKD). To join, please call 702-242-7346 or toll-free 1-877-692-2059, Monday through Friday, 8 a.m. to 5 p.m.

Get equipment to help you complete daily activities. If you’re in need of medical equipment like diabetic supplies, blood pressure monitors, ostomy supplies or breast pumps, call Southwest Medical Pharmacy and Home Medical Equipment at 702-796-1016. Northern Nevada members call 1-800-962-8074, TTY 711.

Understand your pharmacy benefits. A preferred drug list (PDL) is a list of drugs covered under your health plan.

If the medicine your doctor is prescribing is not on the preferred drug list, Health Plan of Nevada may not pay for it or the medicine might require prior approval. If it does, your doctor may call our Pharmacy Services team or send them a prior authorization fax.